More than the passage of time: neonatal health and active labor duration, the mediating role of chorioamnionitis.

Background: Labor intervention is intended to prevent perinatal morbidity and mortality. Labor durations traditionally defined as "dystocia" affect primary cesarean delivery rates. However, there is mixed evidence about the association between labor duration and poor neonatal outcomes.

The Impact of Pancreatic Endotherapy on Quality of Life in Chronic Pancreatitis.

Background And Aims: Pancreatic endotherapy (PET) offers a treatment option for complications of chronic pancreatitis (CP) such as pancreatic duct (PD) strictures, stones, and pseudocysts. As prior studies have primarily focused on how PET affects pain, the primary aim of this study was to evaluate the effect of PET on quality of life.

Methods: This single-center prospective study assessed quality of life before the initiation of endotherapy utilizing a validated CP-specific quality of life instrument (PANQOLI).

Medical language matters: impact of clinical summary composition on a generative artificial intelligence's diagnostic accuracy.

Objectives: Evaluate the impact of problem representation (PR) characteristics on Generative Artificial Intelligence (GAI) diagnostic accuracy.

Methods: Internal medicine attendings and residents from two academic medical centers were given a clinical vignette and instructed to write a PR. Deductive content analysis described the characteristics comprising each PR.

SRC kinase drives multidrug resistance induced by KRAS-G12C inhibition.

Direct targeting of the -mutant protein using covalent inhibitors (G12Ci) acts on human non-small cell lung cancer (NSCLC). However, drug resistance is an emerging concern in this approach. Here, we show that MRTX849, a covalent inhibitor targeting the mutation, leads to the reactivation of the mitogen-activated protein kinase signaling pathway in MRTX849-resistant NSCLC and pancreatic ductal adenocarcinoma.

Streptococcus pneumoniae GAPN is a key metabolic player necessary for host infection.

Streptococcus pneumoniae (S. pneumoniae) employs various metabolic pathways to generate nicotinamide adenine dinucleotide phosphate (NADPH), which is essential for redox balance, fatty acid synthesis, and energy production. GAPN, a non-phosphorylating glyceraldehyde-3-phosphate dehydrogenase, plays a role in this process by directly reducing NADP to NADPH, effectively contributing to glucose metabolism.

Associations of maternal peripregnancy cannabis use with behavioral and developmental outcomes in children with and without symptoms of autism spectrum disorder: Study to Explore Early Development.

Some studies report increased prevalence of autism spectrum disorder (ASD) and associated symptoms with prenatal cannabis exposure. We examined whether associations of maternal cannabis use from 3 months preconception through delivery ("peripregnancy") with behavior and development in the offspring varied with the presence of ASD symptoms. Children ages 30-68 months with ASD symptoms (i.

Co-creating a conceptual model of Indigenous relational wellbeing in early childhood: Planting seeds of connectedness.

The purpose of this article is to share our story of conceptualizing Indigenous early relational wellbeing (ERW), specifically reflecting American Indian and Alaska Native worldviews. Our approach is grounded in Indigenous methodologies and guided by a Community of Learning comprised of Indigenous and allied Tribal early childhood community partners, researchers, practitioners, and federal funders. We describe the steps we took to conceptualize caregiver-child relationships from an Indigenous perspective, center Indigenous values of child development, apply an established Indigenous connectedness framework to early childhood, and co-create a conceptual model of Indigenous ERW to guide future practice and research.

Impaired maternal central hemodynamics precede the onset of vascular disorders of pregnancy at high altitude.

Hypertensive disorders of pregnancy represent an escalating global health concern with increasing incidence in low- to middle-income countries and high-income countries alike. The current lack of methods to detect the subclinical stages of preeclampsia (PE) and fetal growth restriction (FGR), two common vascular disorders of pregnancy, limits treatment options to minimize acute- and long-term adverse outcomes for both mother and child. To determine whether impaired maternal cardiovascular or uteroplacental vascular function precedes the onset of PE and/or FGR (PE-FGR), we used noninvasive techniques to obtain serial measurements of maternal cardiac output (CO), stroke volume (SV), systemic vascular resistance (SVR), and uterine and fetal arterial resistance at , -, and for 79 maternal-infant pairs in La Paz-El Alto, Bolivia (3,850 m), where the chronic hypoxia of high altitude increases the incidence of PE and FGR.

Prevalence of Pathogenic Transthyretin Gene Variants in the Rocky Mountain Region.

Introduction/aims: Hereditary transthyretin amyloidosis (ATTRv) is a genetic condition caused by pathogenic variants in the transthyretin (TTR) gene resulting in multisystem amyloid deposition, especially in peripheral nerve and heart. Information on the prevalence of ATTRv in the United States is limited. The objective of this study was to understand the prevalence and genetic ancestry in the Val142Ile population in a large regional US population.

Are Dinucleotide Alterations Definitional for Myxoid Glioneuronal Tumor? Report of p. K385L Mutation in a Neonatal High-Grade Glioma.

Tumors are increasingly defined by molecular alterations but approach to cases with discordant histologic and molecular features is unclear. Myxoid glioneuronal tumor (MGNT), histologically similar to dysembryoplastic neuroepithelial tumor (DNET), is characterized by dinucleotide mutations in gene (K385L or K385I). Here, we report K385L mutation in a neonatal high-grade glioma.

The influence of early childhood education and care on the relation between early-life social adversity and children's mental health in the environmental influences for Child Health Outcomes Program.

Early adversity increases risk for child mental health difficulties. Stressors in the home environment (e.g.

Things We Do for No Reason™: Avoiding naltrexone for alcohol use disorder in liver disease.

Hospitalizations related to alcohol use disorder (AUD) are common. Yet, few patients receive pharmacotherapy consistent with guideline recommendations. Previous concerns over the potential hepatotoxicity of naltrexone have been disproven and recent studies have shown its safety and efficacy in patients with cirrhosis.

Gaps and opportunities for measuring equity with the Translational Science Benefits Model: Recommendations from the Center for American Indian and Alaska Native Diabetes Translation Research.

Translational research needs to show value through impact on measures that matter to the public, including health and societal benefits. To this end, the Translational Science Benefits Model (TSBM) identified four categories of impact: Clinical, Community, Economic, and Policy. However, TSBM offers limited guidance on how these areas of impact relate to equity.

A 2-year longitudinal investigation of insula subregional volumes in early psychosis.

Background: The insula is a heterogeneous cortical region with three cytoarchitectural subregions-agranular, dysgranular, and granular-that have distinct functional roles. Previous cross-sectional studies have shown smaller volume of all insula subregions in individuals with psychotic disorders. However, longitudinal trajectories of insula subregions in early psychosis, and the relationship between subregional volumes and relevant clinical phenomena, such as perceptual aberrations, have not been previously examined.

Photodegradable polyacrylamide tanglemers enable spatiotemporal control over chain lengthening in high-strength and low-hysteresis hydrogels.

Covalent hydrogel networks suffer from a stiffness-toughness conflict, where increased crosslinking density enhances the modulus of the material but also leads to embrittlement and diminished extensibility. Recently, strategies have been developed to form highly entangled hydrogels, colloquially referred to as tanglemers, by optimizing polymerization conditions to maximize the density and length of polymer chains and minimize the crosslinker concentration. It is challenging to assess entanglements in crosslinked networks beyond approximating their theoretical contribution to mechanical properties; thus, in this work, we synthesize and characterize polyacrylamide tanglemers using a photolabile crosslinker, which allows for direct assessment of covalent trapping of entanglements under tension.

Childhood Educational Outcomes of Infants Born With Esophageal Atresia With or Without Tracheoesophageal Fistula.

Background: There are limited studies on educational outcomes of children born with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF). We aimed to compare 3rd to 5th grade academic proficiency among children born with EA/TEF versus unaffected children.

Methods: Children born with EA/TEF (2000-2005) were identified from the Arkansas Reproductive Health Monitoring System.